An examination of the association between social norms and risky alcohol use among African American men who have sex with men

Background: Alcohol use is associated with increased HIV risk among men who have sex with men (MSM). Less is known about social factors associated with problematic alcohol use among African American men who have sex with men (AA MSM), specifically, the role of alcohol-related social norms. This study examined associations between norms on alcohol use and alcohol risk among an urban sample of AA MSM. Methods: Participants were Black males, aged 18 or older who reported sex with a man in the prior 90 days. A survey assessed problematic alcohol use using the AUDIT, peer norms on alcohol use, and socio-demographics. Independent associations between norms and alcohol use risk (AUR) were examined using logistic regression. Results: Participant (n=147) mean age was 40.8 years (SD=10.9), 20% reported no use of alcohol, 37% were low alcohol risk, 22% hazardous risk and 21% were in the high risk/likely dependent category. As AUR category increased (e.g. risk for dependence) perceptions of friends drinking frequently and in greater quantities increased. Injunctive norms on frequency of alcohol use were also associated with AUR. Results from multivariate logistic regression indicated high alcohol dependence risk was associated with perceptions that peers were drinking frequently and in high quantities after adjusting for HIV status, age and sexual identity. Conclusions: Findings suggest interventions that aim to alter and correct perceptions about problematic alcohol use as an approach to decrease alcohol use behaviors. Examples of one such approach include media campaigns that promote norms of alcohol moderation.